Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $6,309.57 / $12,882.50	Facility		$1,819.70	$6,309.57	$12,882.50
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $9,120.11 / $9,120.11 / $10,471.29	Facility	50	$9,120.11	$9,120.11	$10,471.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $478.63 / $812.83 / $2,344.23	Professional		$478.63	$812.83	$2,344.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $512.86 / $912.01	Professional		$251.19	$512.86	$912.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $6,025.60 / $15,135.61	Facility		$1,698.24	$6,025.60	$15,135.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $758.58 / $1,230.27	Professional		$549.54	$758.58	$1,230.27
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $645.65 / $1,000.00	Professional		$575.44	$645.65	$1,000.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $660.69 / $870.96	Facility		$512.86	$660.69	$870.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $691.83 / $1,230.27	Professional		$537.03	$691.83	$1,230.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21,379.62 / $21,379.62 / $21,379.62	Facility		$21,379.62	$21,379.62	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $758.58 / $1,096.48	Professional		$512.86	$758.58	$1,096.48
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $4,897.79 / $10,000.00	Facility		$2,238.72	$4,897.79	$10,000.00
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $676.08 / $1,096.48	Professional		$416.87	$676.08	$1,096.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $389.05	Professional		$32.36	$33.11	$389.05
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,995.26 / $3,981.07	Facility		$100.00	$1,995.26	$3,981.07
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $676.08 / $1,148.15	Professional		$524.81	$676.08	$1,148.15
United Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $6,165.95 / $10,000.00	Facility		$2,818.38	$6,165.95	$10,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $645.65 / $977.24	Professional		$416.87	$645.65	$977.24